The Worst Tasks
Sometimes technology can make a previously abhorrent task palatable.
For example, take root canals, you think you hate them now? Just imagine how it was before rotary files! When you not only had to find all the canals, you then had to instrument every millimeter by hand. “Finger blisters,” anyone? Rotary files greatly reduced the time and effort needed to perform this procedure making it more accessible to patients and doctors.
Or, how about impressions for crown and bridge? Previously, you had to mix and load the impression material into a syringe before it could be deposited around the tooth for an impression. Can you say “air bubbles” and “you better work fast?” Mixing tips for all sorts of dental materials has made the whole process much more efficient and predictable; now, we don’t even need to take an impression, we can scan to get the needed information to transmit to the lab.
Which brings me to dentures: the bane of many a doctor’s existence. Usually requiring four-ish visits to get the job done; but, is there now a better way? Typically, to create a denture we need to accurately transmit numerous intra-oral contours and relationships to the lab, including:
an accurate impression of the mouth in which the denture is going to sit;
the positioning of the teeth (posterior, anterior, midline, etc.);
an accurate impression of the opposing arch;
and, the relationship of the affected arch to the opposing arch including occlusion and vertical dimension.
If we could do this all in the first visit, then we could deliver on visit two, thereby eliminating at least two visits. This would immediately increase the profitability of this procedure. And, if we could do it using better technology, we might even make the whole process easier on both the dentist and the patient.
How can we get all this information recorded on the very first visit when we meet the patient?
Introducing the Two-Visit Denture
First, a caveat: although there are those that are working on making this more predictable for “from scratch” dentures, I’m going to be discussing the process for a patient that already has an existing denture.
An existing denture contains all the previously mentioned information if used correctly. Start with the intaglio: it probably needs to be replaced to make the denture fit properly again. So, we’ll take a final impression with our favorite material using the existing denture as the custom tray. Check the anterior placement of the incisal edges and midline for accuracy then note any adjustments we might want; the vertical dimension is checked, and desired adjustments noted. Now, scan the denture with the impression material “reline” in place; scan the opposing arch; scan for bite registration; and, we’re done!
We can transmit the scans and notes to the lab that now fabricate a brand-new denture for the patient. Would you really like a try in? No problem! A trial denture can be fabricated and sent for your approval. You will increase the number of visits, but it’s still relatively painless.
The absolute best part of the process is that when your patient puts the new denture in their mouth for the first time it feels familiar. Everything is as they remember it. You’ll still need to adjust the intaglio, but otherwise it’s the same as what they were accustomed to. But, the look on the patient’s face is one of meeting an old friend again.
If you want to see a more complete explanation, you can access Austin Vetter’s webinar on DSN here.
Want to make this even more profitable? Offer a backup denture at the same time for 30% off.
A well-fitting set of dentures can improve the quality of life for many older adults. Studies say that denture wearers live decades less than those with their natural teeth. I’m wondering if the whole process of getting better-fitting dentures is easier, would they get them replaced more often and have better, longer life?
Until next time,
Aaron Nicholas, DDS